Senior Revenue Cycle Consultant

About The Wilshire Group 

The Wilshire Group, a renowned boutique consulting firm in Los Angeles, specializes in revenue cycle optimization and fostering effective collaboration between operational and IT facets.  With a robust track record of aiding over 100 healthcare systems nationwide, our team thrives on professionalism, efficiency, and adaptability.

Our core values- professionalism, efficiency, and flexibility- underscore our commitment to creating an inclusive and dynamic workplace.  We embrace diverse narratives and believe in offering opportunities to exceptional individuals who bring their best to the table.

Senior Revenue Cycle Consultant – Revenue Integrity / HIM

Contract Position | W2 | $100.00/hour | 6+ Months

Position Overview

We are seeking a Senior Revenue Cycle Consultant with deep expertise in Revenue Cycle, Revenue Integrity, and Middle Revenue Cycle operations to support hospital and physician billing optimization initiatives. This role sits above the build layer, partnering with operational and technical stakeholders to guide strategy, workflow optimization, automation, and performance improvement across Hospital Billing (HB), Professional Billing (PB), Coding, and Health Information Management (HIM) functions.

The ideal consultant understands Epic build concepts and downstream impacts but is primarily focused on solution design, validation, governance, and operational outcomes rather than hands-on configuration.

Key Responsibilities

• Serve as a senior advisor for Revenue Integrity and Middle Revenue Cycle initiatives, ensuring alignment across HIM, Coding, HB, PB, and Revenue Cycle leadership

• Lead analysis, design, and optimization of revenue cycle workflows related to coding, charging, documentation, and claim readiness

• Partner with operational and technical teams to evaluate current-state workflows, identify gaps, and recommend scalable, compliant solutions

• Provide oversight and guidance on Epic-related initiatives, ensuring build decisions align with best practices and enterprise revenue strategy

• Support initiatives related to:

  • Coding automation and prioritization

  • Charge capture and revenue integrity workflows

  • Documentation improvement and deficiency management

  • Claim accuracy, denials prevention, and compliance readiness

• Translate complex technical concepts into clear operational guidance for non-technical stakeholders

• Participate in discovery, validation, testing, and go-live support as needed

• Mentor analysts and junior consultants, providing knowledge transfer and best-practice guidance

• Collaborate with Compliance, Privacy, Patient Financial Services, and Clinical stakeholders to support regulatory and organizational goals

Required Qualifications

• 8+ years of progressive experience in Revenue Cycle, HIM, or Revenue Integrity within a healthcare environment

• Strong working knowledge of:

  • Middle Revenue Cycle workflows

  • Hospital Billing (HB) and Professional Billing (PB)

  • Coding operations (facility and professional)

  • HIM processes including documentation, deficiencies, and release of information

• Epic experience with a solid understanding of build concepts, dependencies, and downstream impacts (hands-on build not required)

• Proven ability to operate at a strategic and consultative level, guiding decisions rather than executing configuration

• Experience leading or supporting large-scale optimization, automation, or compliance initiatives

• Excellent analytical, communication, and stakeholder management skills

• Ability to work independently in a fast-paced, client-facing environment

Preferred Qualifications

• Epic certification(s)

• Experience with coding automation, assisted charging, or revenue integrity programs

• Prior consulting experience supporting multi-hospital or integrated delivery systems

• Familiarity with regulatory requirements impacting HIM and Revenue Cycle operations